Early outcome and quality of life post-Mainz Pouch II urinary diversion among bladder cancer patients treated at Kilimanjaro Christian Medical Centre: a 10-year experience
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Abstract
Purpose: Mainz Pouch II is the most common continent type of urinary diversion performed after radical cystectomy for muscle invasive bladder cancer (MIBC) at our facility. This study assesses the early outcomes and quality of life (QoL) post-Mainz Pouch II urinary diversion at Kilimanjaro Christian Medical Centre (KCMC).
Materials and methods: This retrospective cohort study examined all patients who underwent radical cystectomy and Mainz Pouch II urinary diversion at the KCMC urology department from January 2012 to December 2022. Variables assessed included sociodemographic characteristics, clinicopathological disease stage, histological type, early outcome, and QoL. Data were collected from the urology theatre registry book, the Data-Intensive Systems and Applications (DISA) for laboratory results, and the Electronic Health Management System (EHMS) for follow-up information. Clinical pathological characteristics were captured using a data extraction sheet. The World Health Organization (WHO) health-related quality of life (HRQOL) questionnaire was used for QoL assessment. The Statistical Package for the Social Sciences (SPSS) version 25 was used for data analysis.
Results: In this study, 41 subjects underwent Mainz Pouch II, with 78% male. Most patients (97.6%) had T2 clinical stage, while 75.6% had T2 pathological stage, and transitional cell carcinoma (TCC) accounted for 80.5%. Early outcomes included hyperchloremic metabolic acidosis (65.9%), pyelonephritis (4.9%), paralytic ileus (19.5%), wound complications (14.6%), deep vein thrombosis (DVT) (2.4%), acute kidney injury (AKI) (9.8%), and incontinence (12.2%). All subjects had good physical QoL, and 10.7% had poor mental QoL.
Conclusion: Mainz Pouch II is safe with minimal adverse early outcomes and overall good QoL. Further studies on long-term outcomes and determinants of survival are recommended.